Unexpected Lethal Complication of Ventricular Fibrillation in Symptom Free Variant Angina Pectoris

We report an unexpected sudden cardiac death due to variant angina complicated by ventricular fibrillation occurring during routine ambulatory electrocardiographic monitoring. The patient had one previous episode of ventricular fibrillation before the lethal event. He had no significant coronary artery disease and was asymptomatic throughout his illness. In clinical practice, when an episode of ventricular fibrillation is noted, one should be aware of the risk of sudden cardiac death, even if the patient's vasospastic angina is relatively stable and asymptomatic.